Ascension St. Vincent Salem (St. Vincent Salem Hospital, Inc.)
911 N Shelby St, Salem, IN · Ascension · · NPI 1427388982
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Incision of jaw joint CPT 21010 | not published | not published | $184.52 – $1,291.25 | 38 |
| Incision of jaw nerve CPT 64738 | not published | not published | $96.04 – $878.95 | 38 |
| Incision of knee joint CPT 27435 | not published | not published | $200.51 – $1,487.08 | 38 |
| Incision of lymph channels CPT 38308 | not published | not published | $118.33 – $1,438.67 | 38 |
| Incision of metatarsal CPT 28306 | not published | not published | $105.97 – $3,321.81 | 38 |
| Incision of metatarsal CPT 28307 | not published | not published | $119.03 – $3,321.81 | 38 |
| Incision of metatarsal CPT 28308 | not published | not published | $96.56 – $1,487.08 | 38 |
| Incision of metatarsals CPT 28309 | not published | not published | $234.35 – $4,252.91 | 38 |
| Incision of midfoot bones CPT 28304 | not published | not published | $157.17 – $3,321.81 | 38 |
| Incision of palm tendon CPT 26450 | not published | not published | $103.61 – $1,487.08 | 38 |
| Incision of prostate CPT 52450 | not published | not published | $103.13 – $1,592.02 | 38 |
| Incision of pyloric muscle 43520 CPT 43520 | not published | not published | $158.20 – $638.30 | 19 |
| Incision of rectal abscess CPT 46060 | not published | not published | $96.46 – $1,320.79 | 38 |
| Incision of small bowel 44010 CPT 44010 | not published | not published | $191.65 – $862.50 | 19 |
| Incision of sperm duct CPT 55200 | not published | not published | $61.98 – $1,592.02 | 38 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $113.63 – $878.95 | 38 |
| Incision of tendon & muscle CPT 23405 | not published | not published | $159.93 – $3,321.81 | 38 |
| Incision of tendon sheath CPT 25000 | not published | not published | $92.41 – $801.87 | 38 |
| Incision of thigh tendon CPT 27306 | not published | not published | $97.13 – $1,487.08 | 38 |
| Incision of thigh tendon CPT 27390 | not published | not published | $109.42 – $1,487.08 | 38 |
| Incision of thigh tendons CPT 27307 | not published | not published | $118.45 – $1,487.08 | 38 |
| Incision of thigh tendons CPT 27391 | not published | not published | $144.02 – $1,487.08 | 38 |
| Incision of thigh tendons CPT 27392 | not published | not published | $178.74 – $1,487.08 | 38 |
| Incision of tibia CPT 27705 | not published | not published | $197.55 – $4,183.68 | 38 |
| Incision of tibia & fibula CPT 27709 | not published | not published | $277.49 – $8,257.80 | 38 |
| Incision of toe tendons 28011 CPT 28011 | not published | not published | $78.18 – $801.87 | 38 |
| Incision of tongue fold CPT 41010 | not published | not published | $24.50 – $652.86 | 38 |
| Incision of tongue nerve CPT 64740 | not published | not published | $95.54 – $878.95 | 38 |
| Incision of urethra CPT 53000 | not published | not published | $33.34 – $910.38 | 38 |
| Incision of urethra CPT 53010 | not published | not published | $64.38 – $2,419.37 | 38 |
| Incision of urethra CPT 53020 | not published | not published | $21.95 – $910.38 | 38 |
| Incision of urethra CPT 53025 | not published | not published | $15.17 – $910.38 | 38 |
| Incision of windpipe CPT 31601 | not published | not published | $62.24 – $403.80 | 19 |
| Incision of windpipe CPT 31610 | not published | not published | $162.53 – $846.10 | 19 |
| Incision of wrist capsule CPT 25085 | not published | not published | $120.52 – $1,487.08 | 38 |
| Incision secondary cataract CPT 66820 | not published | not published | $92.59 – $1,158.89 | 38 |
| Incision tendon sheath CPT 26055 | not published | not published | $71.77 – $801.87 | 38 |
| Incisn of toe tndn CPT 28010 | not published | not published | $55.16 – $202.39 | 38 |
| Incisn windpipe CPT 31600 | not published | not published | $96.30 – $381.16 | 19 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $89.43 – $652.00 | 19 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $75.36 – $543.82 | 19 |
| Induced abortion d&c CPT 59840 | not published | not published | $38.33 – $1,553.00 | 38 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $64.71 – $1,553.00 | 38 |
| Infect ag drug suscept pheno predict CPT 87900 | not published | not published | $64.37 – $297.20 | 22 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $5.75 – $34.20 | 24 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $5.67 – $32.22 | 24 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $388.20 | $647.00 | $127.14 – $586.99 | 22 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $127.14 – $586.99 | 22 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $63.57 – $293.50 | 22 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $126.40 – $586.99 | 24 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $180.60 | $301.00 | $13.11 – $74.72 | 22 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $5.67 – $80.46 | 24 |
| Infect ag ia optc obs influenza CPT 87804 | $41.40 | $69.00 | $15.83 – $37.73 | 22 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $2.98 – $27.31 | 22 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $7.77 – $41.86 | 24 |
| Infect ag if influenza a CPT 87276 | not published | not published | $5.67 – $36.64 | 24 |
| Infect ag if influenza b CPT 87275 | not published | not published | $5.67 – $27.93 | 22 |
| Infect ag if legionella pneumophila CPT 87278 | $240.00 | $400.00 | $5.75 – $35.57 | 24 |
| Infect ag if nos ea CPT 87299 | not published | not published | $5.67 – $36.71 | 24 |
| Infect ag if pneumocystis carinii CPT 87281 | $244.80 | $408.00 | $5.92 – $27.31 | 22 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $5.67 – $30.60 | 24 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $13.95 – $121.91 | 22 |
| Infect ag na hep b amp CPT 87516 | $277.20 | $462.00 | $17.13 – $80.01 | 24 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $17.13 – $97.68 | 24 |
| Infect ag na hpv high-risk types CPT 87624 | $114.00 | $190.00 | $19.10 – $80.01 | 22 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $432.00 | $720.00 | $47.90 – $218.42 | 22 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $165.60 | $276.00 | $25.34 – $116.99 | 22 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | not published | 0 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,545.00 | $2,575.00 | $229.16 – $950.26 | 22 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $241.31 – $1,114.14 | 22 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $12.87 – $59.44 | 22 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $16.55 – $94.35 | 21 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $216.60 | $361.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $5.92 – $30.60 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $118.20 | $197.00 | $5.67 – $31.51 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $140.40 | $234.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $150.00 | $250.00 | $6.49 – $32.79 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $176.40 | $294.00 | $4.40 – $23.55 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $150.00 | $250.00 | $5.10 – $23.55 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $199.80 | $333.00 | $8.62 – $54.90 | 22 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $164.40 | $274.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $222.00 | $370.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $41.40 | $69.00 | $5.67 – $27.31 | 24 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $349.80 | $583.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $195.60 | $326.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $205.20 | $342.00 | $17.33 – $84.98 | 22 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $205.82 – $950.26 | 22 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $120.60 | $201.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $258.60 | $431.00 | $17.33 – $80.01 | 22 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $441.60 | $736.00 | $17.13 – $95.03 | 24 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $197.40 | $329.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $430.80 | $718.00 | $20.52 – $116.99 | 25 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $129.60 | $216.00 | $57.05 – $325.20 | 21 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $57.05 – $325.20 | 21 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $17.13 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $176.40 | $294.00 | $19.15 – $80.01 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,122.60 | $1,871.00 | $205.82 – $950.26 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $63.35 – $292.50 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $105.40 – $599.62 | 22 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $591.00 | $985.00 | $20.26 – $97.68 | 24 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.